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Is Regestrone And Mirena Advisable For Vaginal Spotting And Bleeding?
Question: My wife aged 48 years, diabetic since last 8 years, as per USG is having a Nabothian Cyst. She is suffering continued spotting/bleeding which stopped since last 10 days upon taking Regestrone 5mg twice daily. She is advised to take Mirena. Is it advisable. What could be other options, seek your valued guidance please? May please also suggest if any further examintion is required.
Brief Answer:
AS BELOW
Detailed Answer:
Hello
Thanks for writing to us with your health concern.
1. A nabothian cyst is a normal age related change, nothing needs to be done for it.
2. As the ultrasound and clinical exam is normal, the bleeding is mostly due to hormonal disturbance. As it is controlled with Regestrone, she has two options - take cyclical Progesterone therapy for a few months ( 3 - 6 months ) or go for Mirena insertion. She would soon attain menopause, when the problem would subside. Mirena also contains progesterone, the basic action of Regestrone / Mirena is the same - controls hormonal disturbances. FSH, LH, TSH, Prolactin levels and latest blood sugars should be done, plus a Pap smear.
3. Control blood sugars.
4. Have regular 3 monthly gynecological check ups and Pap smear.
All the best
Please feel free to discuss further.
AS BELOW
Detailed Answer:
Hello
Thanks for writing to us with your health concern.
1. A nabothian cyst is a normal age related change, nothing needs to be done for it.
2. As the ultrasound and clinical exam is normal, the bleeding is mostly due to hormonal disturbance. As it is controlled with Regestrone, she has two options - take cyclical Progesterone therapy for a few months ( 3 - 6 months ) or go for Mirena insertion. She would soon attain menopause, when the problem would subside. Mirena also contains progesterone, the basic action of Regestrone / Mirena is the same - controls hormonal disturbances. FSH, LH, TSH, Prolactin levels and latest blood sugars should be done, plus a Pap smear.
3. Control blood sugars.
4. Have regular 3 monthly gynecological check ups and Pap smear.
All the best
Please feel free to discuss further.
Above answer was peer-reviewed by :
Dr. Yogesh D
Few more concerns:
1. Hope there is no need to do any scanning for cancer / biopsy at the moment.
2. She is trying to control her sugar levels by medicine and brisk walking for 45 minutes daily - hope walking can continue.
3. HBA1C in XXXXXXX was 6.8, last 10 days back it has risen to 7.3. Hope it will subside gradually.
4. When to do a Pap Smear? Why it is suggested to have the test? She had undergone Pap Smear in 2011, she is somehow averse to take the test. What is your valued advise on this.
5. Can we have sex, will it not aggravate the nabothin cyst / fibroid, she is paranoid?
6. Her BMI is okay. Considering her sugar getting high - Which is the better option Mirena or Progesterone ? How is Progesterone adminstered?
7. Any other valued advise.
regards,
1. Hope there is no need to do any scanning for cancer / biopsy at the moment.
2. She is trying to control her sugar levels by medicine and brisk walking for 45 minutes daily - hope walking can continue.
3. HBA1C in XXXXXXX was 6.8, last 10 days back it has risen to 7.3. Hope it will subside gradually.
4. When to do a Pap Smear? Why it is suggested to have the test? She had undergone Pap Smear in 2011, she is somehow averse to take the test. What is your valued advise on this.
5. Can we have sex, will it not aggravate the nabothin cyst / fibroid, she is paranoid?
6. Her BMI is okay. Considering her sugar getting high - Which is the better option Mirena or Progesterone ? How is Progesterone adminstered?
7. Any other valued advise.
regards,
Brief Answer:
specific answers are below
Detailed Answer:
1. Cervical Pap smear is screening for cervical cancer. Other than that, there is no need for any further screening.
2. What are her latest blood sugars ? If you let me know the values, I can tell you if further medications / insulin is required to control blood sugar levels. Also, what medication is she taking ? Diet restriction is a must for any kind of diabetic patient.
3. It would mostly not subside without treatment.
4. A Pap smear can be done after periods, anytime, avoiding sexual activity for 3 days prior. IT is suggested in all women yearly . She should repeat the test, if done in 2011 last. There is nothing to be averse about it.
5. Sex will NOT aggravate her problems in any way.
6. Mirena is the better option, I need to know her latest blood sugars though.
7. Progesterone is administered as tablets - from 15th to 25th day of each cycle, or as injections, or as a vaginal tablet / gel or as Intrauterine Device ( Mirena ).
Take care.
specific answers are below
Detailed Answer:
1. Cervical Pap smear is screening for cervical cancer. Other than that, there is no need for any further screening.
2. What are her latest blood sugars ? If you let me know the values, I can tell you if further medications / insulin is required to control blood sugar levels. Also, what medication is she taking ? Diet restriction is a must for any kind of diabetic patient.
3. It would mostly not subside without treatment.
4. A Pap smear can be done after periods, anytime, avoiding sexual activity for 3 days prior. IT is suggested in all women yearly . She should repeat the test, if done in 2011 last. There is nothing to be averse about it.
5. Sex will NOT aggravate her problems in any way.
6. Mirena is the better option, I need to know her latest blood sugars though.
7. Progesterone is administered as tablets - from 15th to 25th day of each cycle, or as injections, or as a vaginal tablet / gel or as Intrauterine Device ( Mirena ).
Take care.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Many thanks Doc. I have certain further queries.
1. Her latest sugar Fasting is 138 / HBAIC 7.3 (report of 19.4.14 attached). She is taking - Pioglit MF 15 Twice, Diamicorn XR 500 Twice, Telma CT, restricted diet, regular walking brisk walking for 2-2.5 Kms. The HBA1C done in 4.1.14 was 6.8, since thereafter, her sugar levels are fluctuating and the doses sugar medicines have been increased. [Till XXXXXXX 14, she used to take Glychipage G2 (Twice) and Janument 50/500 once. It more or less kept the sugar level under control for more than 3 years. ] >> May please suggest if there needs to any further change in medicines for sugar control. I have attached the latest prescription of the diabetologist.
2. Any probable side effects of inserting Mirena? Any precautions to be taken ?
3. The Mirena once inserted, needs to taken out during periods or it will continue to be as it is for such time she menopauses?
4. Earlier she did not used to walk during her periods. But given the prolong spotting that started in XXXXXXX this year (under control since last two weeks), she used to walk even during spotting / regular flow. Is walking in such situations advisable.
5. She says walking in treadmill increases the spotting, is there any such link?
6. There are certain supplements of Amway - Nutrilite, is it advisable to take?
If you please give your valued advise.
regards
1. Her latest sugar Fasting is 138 / HBAIC 7.3 (report of 19.4.14 attached). She is taking - Pioglit MF 15 Twice, Diamicorn XR 500 Twice, Telma CT, restricted diet, regular walking brisk walking for 2-2.5 Kms. The HBA1C done in 4.1.14 was 6.8, since thereafter, her sugar levels are fluctuating and the doses sugar medicines have been increased. [Till XXXXXXX 14, she used to take Glychipage G2 (Twice) and Janument 50/500 once. It more or less kept the sugar level under control for more than 3 years. ] >> May please suggest if there needs to any further change in medicines for sugar control. I have attached the latest prescription of the diabetologist.
2. Any probable side effects of inserting Mirena? Any precautions to be taken ?
3. The Mirena once inserted, needs to taken out during periods or it will continue to be as it is for such time she menopauses?
4. Earlier she did not used to walk during her periods. But given the prolong spotting that started in XXXXXXX this year (under control since last two weeks), she used to walk even during spotting / regular flow. Is walking in such situations advisable.
5. She says walking in treadmill increases the spotting, is there any such link?
6. There are certain supplements of Amway - Nutrilite, is it advisable to take?
If you please give your valued advise.
regards
Brief Answer:
AS BELOW
Detailed Answer:
Hello again.
1. The treatment suggested by the diabetologist is perfect. Please follow him.
2. Mirena has certain side effects - spotting, probable derangement of blood sugars and liver enzymes, breast tenderness, mood changes, weight gain . These do not occur in all women and are minor and go away with time. The benefits are more than the side effects.
3. It can be kept in situ for 5 years, not to be removed during periods.
4. Yes, walking and exercise are only beneficial .
5. There is no such corelation.
6. No supplements are scientifically approved.
Take care.
AS BELOW
Detailed Answer:
Hello again.
1. The treatment suggested by the diabetologist is perfect. Please follow him.
2. Mirena has certain side effects - spotting, probable derangement of blood sugars and liver enzymes, breast tenderness, mood changes, weight gain . These do not occur in all women and are minor and go away with time. The benefits are more than the side effects.
3. It can be kept in situ for 5 years, not to be removed during periods.
4. Yes, walking and exercise are only beneficial .
5. There is no such corelation.
6. No supplements are scientifically approved.
Take care.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
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